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Patient Assessment Methods I > Bell's Palsy, Stroke, Horner's Syndrome > Flashcards

Bell's Palsy, Stroke, Horner's Syndrome Flashcards

1
Q

Where do symptoms occur in Bell’s palsy vs stroke?

A

Bell’s palsy: facial nerve symptoms only
Stroke: symptoms in extremities

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2
Q

How is the face affected by Bell’s palsy?

A

Entire unilateral face affected; won’t be able to close eye or smile, droopy lip, and cannot wrinkle forehead with raising the eyebrows

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3
Q

How is the face affected by stroke?

A

Lower face only; will be able to close eye and wrinkle forehead with a frown, weak smile but can do

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4
Q

Will Bell’s palsy present peripheral nerve symptoms or central nervous system symptoms?

A

Peripheral nerve symptoms

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5
Q

Will stroke present peripheral nerve symptoms or central nervous system symptoms?

A

Central nervous system symptoms

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6
Q

What is a transient ischemic attack?

A

Module of neurologic deficit lasting from seconds to hours; usually considered a warning sign of impending thrombotic stroke – micro emboli

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7
Q

About ___% of transient ischemic attacks eventually lead to stroke

A

40%

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8
Q

What is the acronym FAST for stroke/TIA?

A
  • Face drooping, ask patient to smile
  • Asymmetry and arm weakness; ask patient to raise both arms palms up (look for pronator drift)
  • Speech difficulty; ask patient to repeat a simple sentence
  • Time to call 911
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9
Q

What is a cerebral vascular accident?

A

Sudden impairment of cerebral circulation in one or more blood vessels supplying the brain; interruption or diminished oxygen supply which causes damage and necrosis to brain tissue

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10
Q

___% of patients remain permanently disable after cerebral vascular accident

A

50%

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11
Q

What are some causes of cerebral vascular accident?

A

Clot in the brain, emboli from the heart, sometimes an aneurysm (thrombosis, embolism, and hemorrhage)

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12
Q

The following are all risk factors for what?

  • Atherosclerosis
  • Hypertension
  • Kidney disease
  • Arrhythmias – atrial fibrillation
  • Transient ischemic attack
A

Stroke

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13
Q

The following are all risk factors for what?

  • Diabetes Mellites
  • Birth control pills
  • Smoking
  • Family history
  • Transient ischemic attack
A

Stroke

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14
Q

What are generalized symptoms and signs of stroke?

A
  • Sudden HA
  • Vision changes
  • Disorientation
  • Vomiting
  • Mental impairment
  • Seizures
  • Coma
  • Fever
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15
Q

What is used to diagnose stroke?

A
  • Observation of clinical features
  • History
  • CT
  • MRI
  • Angiography
  • EEG
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16
Q

What are some treatments for stroke?

A

Surgery, clot dissolvers such as tissue plasminogen activator (TPA) effective if given asap, later heparin, Coumadin, and antiplatelet drugs

17
Q

What are some methods of post cerebral vascular accident rehab?

A

PT, OT, speech therapy
Chiropractic and acupuncture play a role

18
Q

What is injured in Horner’s syndrome?

A

Lower cervical ganglion aka stellate ganglion lesion

19
Q

The stellate ganglion is composed of the ___ and ___, which are fused together in 80% of the general population

A

inferior cervical ganglion (C7) and proximal thoracic ganglion (T1)

20
Q

Where is the stellate ganglion typically found in the body?

A

Usually anterior to the neck of the first rib and extends into interspace between C7 and T1 vertebral bodies
May rest on the anterior tubercle of C7 if elongated

21
Q

In one study, 33% of patients with brainstem lesions (brainstem stroke or tumor or syrinx of the preganglionic neuron) demonstrated…

A

Horner’s syndrome

22
Q

In one study, 44% of patients with internal extracranial carotid artery dissection had ___, which remained isolated in half the cases

A

painful Horner syndrome

23
Q

The following are all causes of what?

  • Trauma to the brachial plexus
  • Tumors (Pancoast) or infection of the lung apex
  • Lesion of primary or postganglionic neuron
  • Carotid artery ischemia
  • Migraine
  • Middle cranial fossa neoplasm
A

Horner’s syndrome

24
Q

Which cranial nerves are affected by acoustic neuroma?

A

CN VII facial and CN VIII vestibulocochlear

25
Q

How does an acoustic neuroma affect the corneal reflex?

A

Corneal reflex will be absent on the affected side only because it puts pressure on CN VII (also tested with CN V)

Patient Assessment Methods I (22 decks)

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